A simulation based difficult conversations intervention for neonatal intensive care unit nurse practitioners: A randomized controlled trial

Abstract

BackgroundNeonatal nurse practitioners are often the front line providers in discussing unexpected news with parents. This study seeks to evaluate whether a simulation based Difficult Conversations Workshop for neonatal nurse practitioners leads to improved skills in conducting difficult conversations.

Improving Patient- and Family-Centered Communication in Pediatrics: A Review of Simulation-Based Learning

“…Standardized portrayals imply that the personnel involved have undergone formal training, which may include orientation to situational and psychosocial background, [31][32][33] standardization of respective role representation and emotional tone, 7 explanation of explicit goals and objectives, 7 and standardization of feedback techniques. 7 Programs using a standardized approach included those that employed standardized patients (SPs) (from established simulation centers or SP programs ), 12,24,26,[34][35][36] hired actors, [5][6][7][8]14,16,[37][38][39] actual trained parents, 2,9,25,40 or trained children and adolescents. 31 Implementing standardized portrayals has the advantage of creating a more psychologically safe environment and allowing for standardized assessments and feedback.…”

“…6,12,29,37,41,[46][47][48] Most used blinded or faculty raters (less commonly SPs 12 ) to evaluate post-intervention simulated conversation 6,12,29,41,46-48 using standardized checklists 41 (SPIKES, 12 Kalamazoo Consensus Statement, 24,29,47 Calgary-Cambridge Observation Guide Checklist 46 ) or institution-specific checklists (developed by local content experts, often based on a summation of literature). 6,48 Two studies used standardized checklists during the intervention for the purpose of providing feedback and stimulating discussion. 15,37 Two studies uniquely scored participants on empathy, 6,16 and three studies attempted to assess retention of skills up to 6 months SPECIAL ISSUE ARTICLE post-intervention.…”

“…6,48 Two studies used standardized checklists during the intervention for the purpose of providing feedback and stimulating discussion. 15,37 Two studies uniquely scored participants on empathy, 6,16 and three studies attempted to assess retention of skills up to 6 months SPECIAL ISSUE ARTICLE post-intervention. 12,45,47 Generally, studies were able to show improvement in learners' skill pre-and post-intervention.…”

“…5 Fortunately, communication skills training has gained significant traction in the last decade. It is now generally accepted that communication skills can and should be taught [6][7][8][9][10][11] and communication skills training has thus found a place in the curricula of many nursing, undergraduate, and postgraduate medical training programs. It has been suggested that communication skills are best gained through experiential learning 12 and simulation is just that.…”

“…Simulation has proven an effective methodology to improve teamwork, medical knowledge, procedural competence, and communication. 6,13 Despite these developments, an educational gap still exists regarding communication skills training and a desire for more and different types of education is frequently voiced in the literature. For example, Boss et al, 14 found that nearly one-half of surveyed graduating neonatology fellows had no formal training in communication skills and nearly all desired more education.…”